Robotic surgery for prostate cancer: what is radical prostatectomy and how the Da Vinci robot improves it

Health/June 19, 2025

Radical prostatectomy has become one of the most effective treatments for localized prostate cancer, involving complete removal of the prostate gland and usually the seminal vesicles. It is a curative surgical procedure, mainly recommended for patients with an early diagnosis of prostate cancer, when the tumor is still confined to the gland and has not spread to other parts of the body.

In recent years, the introduction of Da Vinci robot-assisted surgery has revolutionized this procedure, making it possible to operate with precision and safety previously unattainable. This type of surgery is recommended for clinical stages T1 and T2, and aims to completely remove the tumor before it has time to spread. According to specialists, it is particularly suitable for men in good general health, with sufficient life expectancy to benefit from long-term curative treatment.

The main goal of radical prostatectomy is to completely remove the cancer before it spreads

— emphasizes Dr. Manuel Ruibal, a urological robotic surgery specialist at Quirónsalud Torrevieja Hospital.

The evolution of surgery: from open prostatectomy to the Da Vinci robot

Traditionally, radical prostatectomy was performed using an open approach, which meant a wide incision in the lower abdomen and direct but limited vision of the surgical field. The advent of laparoscopic techniques was a major step toward less invasive procedures. But the real change came with the introduction of Da Vinci robot-assisted surgery, combining the advantages of both techniques with unprecedented surgical precision.

The Da Vinci robot allows the surgeon to operate from a console, controlling the robotic arms that perform movements with millimeter accuracy, eliminating hand tremors and providing high-resolution 3D imaging.

Differences between traditional and Da Vinci robotic prostatectomy

Da Vinci robotic surgery represents a significant advance over traditional open surgery. The conventional technique requires a large incision and offers limited visibility of the surgical field, while the robotic system allows surgery through small incisions with millimeter precision and 3D vision in HD.

With the Da Vinci robot, we eliminate hand tremors and make more precise movements, which is crucial for maintaining functions such as incontinence and sexual function,

— Dr. Ruibal explains.

Notch type:
- Traditional: wide incisions, more tissue damage and risk of complications.
- Robotic: minimal incisions, less trauma and faster recovery.
Precision:
- Traditional: dependent on manual skills, prone to tremors and fatigue.
- Robotic: very high due to robot control, stable and precise movements.
Visibility of the operating field:
- Traditional: 2D image, difficulty in assessing depth.
- Robotic: 3D HD image, better visibility of structures.
Recovery time:
- Traditional: longer, more pain and risk of infection.
- Robotic: faster, less bleeding and less trauma.
Protection of key structures:
- Traditional: more difficult due to limited precision.
- Robotic: better with advanced technology, which improves postoperative function.

The Da Vinci robot does not operate autonomously — the surgeon controls each movement from an ergonomic console in the operating room. The system translates the surgeon's movements into precise tool actions in real time, minimizing damage to surrounding tissues and increasing the safety of the procedure.

The difference is not just the technology, but how it is used. The experience of the surgical team is key to getting the most out of Da Vinci,

— Dr. Ruibal emphasizes.

Who can benefit from robotic prostatectomy?

The procedure is recommended for patients with early, localized prostate cancer, in good general condition, able to undertake major surgery and benefit from long-term treatment. Sometimes the technique is also used for patients with locally advanced cancer, if clinical conditions are appropriate and recommendations from the multidisciplinary team.

The procedure is particularly valuable for younger patients who are physically and sexually active, as the robot allows better protection of the structures responsible for these functions.

Robotic prostatectomy has many benefits, including less bleeding during surgery, lower risk of complications, faster recovery and shorter hospital stay.

Patients feel the difference on the first day - they walk faster, eat faster and go home with more independence. This is impossible with traditional surgery.

Despite concerns about potential loss of erectile function or incontinence, the risk of these complications has decreased significantly due to the robot's precision, which promotes faster and better rehabilitation, especially in younger patients.

Studies show that the oncological results of robotic surgery are comparable to open surgery. The experience of the team and appropriate patient selection make the difference.

At Quirónsalud Torrevieja Hospital, Da Vinci robotic surgery has been used for more than two years. It is currently the only private center in the province of Alicante with this technology to treat prostate cancer, becoming a leader in minimally invasive urological surgery.